Lactoferrin and lysozyme to promote nutritional, clinical and enteric recovery: a protocol for a factorial, blinded, placebo-controlled randomised trial among children with diarrhoea and malnutrition (the Boresha Afya trial)

Introduction: Children with moderate or severe wasting are at particularly high risk of recurrent or persistent diarrhoea, nutritional deterioration and death following a diarrhoeal episode. Lactoferrin and lysozyme are nutritional supplements that may reduce the risk of recurrent diarrhoeal episodes and accelerate nutritional recovery by treating or preventing underlying enteric infections and/or improving enteric function. Methods and analysis: In this factorial, blinded, placebo-controlled randomised trial, we aim to determine the efficacy of lactoferrin and lysozyme supplementation in decreasing diarrhoea incidence and improving nutritional recovery in Kenyan children convalescing from comorbid diarrhoea and wasting. Six hundred children aged 6–24 months with mid-upper arm circumference \u3c12.5 cm who are returning home after an outpatient visit or inpatient hospital stay for diarrhoea will be enrolled. Children will be randomised to 16 weeks of lactoferrin, lysozyme, a combination of the two, or placebo and followed for 24 weeks, with biweekly home visits by community health workers and clinic visits at 4, 10, 16 and 24 weeks. The primary analysis will compare the incidence of moderate-to-severe diarrhoea and time to nutritional recovery between each intervention arm and placebo. The trial will also test whether these interventions reduce enteric pathogen carriage, decrease enteric permeability and/or increase haemoglobin concentration in enrolled children. Finally, we will evaluate the acceptability, adherence and cost-effectiveness of lactoferrin and/or lysozyme. Ethics and dissemination: The trial has been approved by the institutional review boards of the Kenya Medical Research Institute, the University of Washington, the Kenyan Pharmacy and Poisons Board, and the Kenyan National Commission on Science, Technology and Innovation. The results of this trial will be shared with local and international stakeholders and published in peer-reviewed journals, and the key findings will be presented at relevant conferences

Forest biomass diversion in the Sierra Nevada: Energy, economics and emissions

As an alternative to open pile burning, use of forest wastes from fuel hazard reduction projects at Blodgett Forest Research Station for electricity production was shown to produce energy and emission benefits: energy (diesel fuel) expended for processing and transport was 2.5% of the biomass fuel (energy equivalent); based on measurements from a large pile burn, air emissions reductions were 98%-99% for PM2.5, CO (carbon monoxide), NMOC (nonmethane organic compounds), CH4 (methane) and BC (black carbon), and 20% for NOx and CO2-equivalent greenhouse gases. Due to transport challenges and delays, delivered cost was $70 per bone dry ton (BDT) - comprised of collection and processing ($34/BDT) and transport ($36/BDT) for 79 miles one way - which exceeded the biomass plant gate price of$45/BDT. Under typical conditions, the break-even haul distance would be approximately 30 miles one way, with a collection and processing cost of $30/BDT and a transport cost of$16/BDT. Revenue generated from monetization of the reductions in air emissions has the potential to make forest fuel reduction projects more economically viable

Crop pests and predators exhibit inconsistent responses to surrounding landscape composition

The idea that noncrop habitat enhances pest control and represents a win–win opportunity to conserve biodiversity and bolster yields has emerged as an agroecological paradigm. However, while noncrop habitat in landscapes surrounding farms sometimes benefits pest predators, natural enemy responses remain heterogeneous across studies and effects on pests are inconclusive. The observed heterogeneity in species responses to noncrop habitat may be biological in origin or could result from variation in how habitat and biocontrol are measured. Here, we use a pest-control database encompassing 132 studies and 6,759 sites worldwide to model natural enemy and pest abundances, predation rates, and crop damage as a function of landscape composition. Our results showed that although landscape composition explained significant variation within studies, pest and enemy abundances, predation rates, crop damage, and yields each exhibited different responses across studies, sometimes increasing and sometimes decreasing in landscapes with more noncrop habitat but overall showing no consistent trend. Thus, models that used landscape-composition variables to predict pest-control dynamics demonstrated little potential to explain variation across studies, though prediction did improve when comparing studies with similar crop and landscape features. Overall, our work shows that surrounding noncrop habitat does not consistently improve pest management, meaning habitat conservation may bolster production in some systems and depress yields in others. Future efforts to develop tools that inform farmers when habitat conservation truly represents a win–win would benefit from increased understanding of how landscape effects are modulated by local farm management and the biology of pests and their enemies

Trends and emerging directions in HIV risk and prevention research in the Philippines: A systematic review of the literature.

BackgroundThe Philippines is experiencing one of the fastest growing epidemics globally. Evidence-based public health policies are needed. To describe the public health literature on HIV risk groups and prevention approaches in the Philippines, we reviewed published empirical studies with HIV-related outcomes.MethodsBased on an a priori systematic review protocol, we searched PubMed, PsycINFO and CINAHL databases for quantitative studies conducted in the Philippines that reported on HIV risk groups factors and interventions to prevent HIV. The search included studies published as of April 2018.ResultsWe identified 755 records, screened 699 unique titles and abstracts, and conducted full text review of 122 full reports of which 51 articles met inclusion criteria. The majority were cross-sectional studies describing HIV and STI prevalence and risk factors in samples recruited from the Philippines. Four HIV prevention programs conducted in the Philippines were identified, all of which reported improvements on HIV knowledge, attitudes, and behaviors. Overall, female sex workers (FSWs) constituted the primary study population, and few studies reported data from men who have sex with men (MSM), people who inject drugs (PWIDs), and youth. No studies reported on transgender populations. Most studies were focused on examining condom use-related outcomes and STI history, few had biomarkers for HIV, and none addressed biomedical HIV prevention strategies.ConclusionThis review identifies an agenda for future HIV research that is needed to address the growing and shifting nature of the HIV epidemic in the Philippines

Forest biomass diversion in the Sierra Nevada: Energy, economics and emissions

As an alternative to open pile burning, use of forest wastes from fuel hazard reduction projects at Blodgett Forest Research Station for electricity production was shown to produce energy and emission benefits: energy (diesel fuel) expended for processing and transport was 2.5% of the biomass fuel (energy equivalent); based on measurements from a large pile burn, air emissions reductions were 98%-99% for PM2.5, CO (carbon monoxide), NMOC (nonmethane organic compounds), CH4 (methane) and BC (black carbon), and 20% for NOx and CO2-equivalent greenhouse gases. Due to transport challenges and delays, delivered cost was $70 per bone dry ton (BDT) - comprised of collection and processing ($34/BDT) and transport ($36/BDT) for 79 miles one way - which exceeded the biomass plant gate price of$45/BDT. Under typical conditions, the break-even haul distance would be approximately 30 miles one way, with a collection and processing cost of $30/BDT and a transport cost of$16/BDT. Revenue generated from monetization of the reductions in air emissions has the potential to make forest fuel reduction projects more economically viable

Forest biomass diversion in the Sierra Nevada: Energy, economics and emissions

As an alternative to open pile burning, use of forest wastes from fuel hazard reduction projects at Blodgett Forest Research Station for electricity production was shown to produce energy and emission benefits: energy (diesel fuel) expended for processing and transport was 2.5% of the biomass fuel (energy equivalent); based on measurements from a large pile burn, air emissions reductions were 98%-99% for PM2.5, CO (carbon monoxide), NMOC (nonmethane organic compounds), CH4 (methane) and BC (black carbon), and 20% for NOx and CO2-equivalent greenhouse gases. Due to transport challenges and delays, delivered cost was $70 per bone dry ton (BDT) — comprised of collection and processing ($34/BDT) and transport ($36/BDT) for 79 miles one way— which exceeded the biomass plant gate price of$45/BDT. Under typical conditions, the break-even haul distance would be approximately 30 miles one way, with a collection and processing cost of $30/BDT and a transport cost of$16/BDT. Revenue generated from monetization of the reductions in air emissions has the potential to make forest fuel reduction projects more economically viable

Forest biomass diversion in the Sierra Nevada: Energy, economics and emissions

As an alternative to open pile burning, use of forest wastes from fuel hazard reduction projects at Blodgett Forest Research Station for electricity production was shown to produce energy and emission benefits: energy (diesel fuel) expended for processing and transport was 2.5% of the biomass fuel (energy equivalent); based on measurements from a large pile burn, air emissions reductions were 98%-99% for PM2.5, CO (carbon monoxide), NMOC (nonmethane organic compounds), CH4 (methane) and BC (black carbon), and 20% for NOx and CO2-equivalent greenhouse gases. Due to transport challenges and delays, delivered cost was $70 per bone dry ton (BDT) — comprised of collection and processing ($34/BDT) and transport ($36/BDT) for 79 miles one way— which exceeded the biomass plant gate price of$45/BDT. Under typical conditions, the break-even haul distance would be approximately 30 miles one way, with a collection and processing cost of $30/BDT and a transport cost of$16/BDT. Revenue generated from monetization of the reductions in air emissions has the potential to make forest fuel reduction projects more economically viable